1. National Alliance for Physician Competence January 15, 2007 St. Petersburg, FL

2. Medical Profession Public/ Consumers/ Patients Social Contract

3. Medical Profession Public/ Consumers/ Patients Social Contract

4. Medical Profession Public/ Consumers/ Patients Social Contract

5. Public/ Consumers/ Patients Social Contract The Medical Profession

6. Summit 1 The primary question driving the creation of scenarios was: how does the healthcare community determine, measure and assure the public concerning physician competence over the career of the physician? But we were to address this indirectly….

7. Summit 1 - Process Significant events over the last 100 years Key factors/driving forces over next 15 years Generate scenarios to explore possible futures

8. 1 – Techno Community 2 – Data Cacaphony 3 – Federal Tarbaby 4 – Brave New World 5 – happy healthcare.com Driving event Costs Public dsstsfctn Misaligned incentvs Overutilization Mandated EHR Costs; burden shifted Erosion of trust Value-driven consumr EHRs fail Costs and errors Universal health coverage No-fault system Mandated data reporting & EHRTechnology Costs Public dissatisfaction Value-driven consumr Demand for better data CQI model Health savings accounts CONSEQUENCES Health CareMore non-traditional care Outsourcing More non-traditional care Outsourcing More non-tradtnl care Emphasis on disease prevention Web-based triage Self-serve care (Health Depot) Outsourcing RegulatoryConsortium develops performance standards based on data in central repository Health care orgs collect performance data – but no one will collaborate on national standards Legislators make it worse National Office of the Secretary of HealthOversight of Accreditation and Licensure is Nationalized International certification Federally funded regional partnerships manage perf data used in licensure Watchdog industry emerges Licensing boards hold docs accountable for outcomes (rather than min standards) Data/ Standards Data available to public Data and standards conflicts result Performance standards developed regionally, monitored nationally Physician role/ Assessment Assessment tools developed to evaluate performance of health system Team leader Regional integrated delivery systems employ all, and monitor competence of individuals and teams Teaching institutions benefit from downstream information Professional vs. Federal Intervention Data Standards and Sharing Cost and Consumer Dissatisfaction

9. Summit 2-3 Recommendations Formation of a National Alliance Definition of competence Mechanism for ensuring competence – lifelong learning portfolio

10. Public/ Consumers/ Patients Social Contract The Medical Profession

11. AMA Public/ Consumers/ Patients CMSS AAMC ACGME JCAHO AHA NBME ECFMG ABMS FSMB ACCME ABIM ACS SMBs ACP CMS BC/BS Social Contract

12. AMA Public/ Consumers/ Patients CMSS AAMC ACGME JCAHO AHA NBME ECFMG ABMS FSMB ACCME ABIM ACS SMBs ACP AARP CU Public Voices CMS BC/BS Social Contract

13. Public/ Consumers/ Patients National Alliance for Physician Competence Social Contract

14. Public/ Consumers/ Patients National Alliance for Physician Competence Social Contract

15. National Alliance for Physician Competence Public/ Consumers/ Patients Social Contract Definition of Competence – Good Medical Practice – USA Training Level/Specialty Translators Lifelong Learning Portfolio Tools/Analyses/Measures

16. National Alliance for Physician Competence Public/ Consumers/ Patients Social Contract Definition of Competence – Good Medical Practice – USA Training Level/Specialty Translators Lifelong Learning Portfolio Public Report Individ/ Profess Access Tools/Analyses/Measures